Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sagebrush Dermatology PLLC

Organization Dermatology Physician · NPI 1174274435

Sagebrush Dermatology PLLC is a Dermatology Physician in Mesa, Arizona. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5432 E Southern Ave Ste 101B
Mesa, AZ 85206-2772
Phone: (480) 681-3376
Fax: (480) 681-3372
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Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1174274435
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chao Li — Owner · (480) 681-3376
NPI enumeratedJanuary 18, 2022
Last updated in NPPESMarch 3, 2022
Certification dateMarch 3, 2022
Mailing address5432 E Southern Ave Ste 101b, Mesa, AZ 85206-2772

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